Healthcare Provider Details

I. General information

NPI: 1801842943
Provider Name (Legal Business Name): SEAN ADAM FISCHER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 01/16/2024
Certification Date: 01/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 SANTA MONICA BLVD STE 560W
SANTA MONICA CA
90404-2182
US

IV. Provider business mailing address

2021 SANTA MONICA BLVD SUITE 400E
SANTA MONICA CA
90404-2208
US

V. Phone/Fax

Practice location:
  • Phone: 310-453-5654
  • Fax: 310-453-6885
Mailing address:
  • Phone: 310-453-5654
  • Fax: 310-453-6885

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberA95048
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: